BSMMU MD Residency Syllabus : Medicine and Allied Phase - A

Medicine and Allied Phase - A Residency Syllabus- BSMMU

The aim of the syllabus for Phase A training is to guide the Residents to acquire broad based knowledge on Medicine before entering the Phase B specialty-specific training. Patients present

themselves with problems and it is the problem that needs solving. A specialist who has broad based knowledge of Medicine will be able to solve the problem in a better way. So the ultimate objective of Phase A training is to produce a knowledgeable, competent, altruistic specialist with up to date background
knowledge of Medicine. Emphasis has been laid on common diseases frequently encountered in this part of the world.
By the end of Phase A Training (Core Medical Training) the Resident should be able to:
a. Assess presenting symptoms and signs
b. Formulate appropriate investigations and accurately interpret
investigation reports
c. Communicate the diagnosis and prognosis
d. Institute appropriate treatment recognizing indications,
contraindications and side effects of common clinical conditions:
On this background, it is expected that Residents will be able to:
(i) acquire knowledge lof common medical conditions,emergencies, & rehabilitations].
(1) acquire skills (diagnostic,clinical and decision making) and (iii) develop attitude (caring,learning, & ethical).


11.1. Learning Objectives:

A. CLINICAL SKILLS
1. Elicit the history and obtain other relevant data
2. Conduct an appropriate physical examination
3. Synthesize findings from history and physical examination to
develop differential diagnoses, identify problems, make
problem list and formulate management plan
4. Plan and arrange investigations appropriately

B. PATIENT CARE AND THERAPEUTICS
1. Manage general care in the unwell patient
2. Prescribe appropriate and safe pharmacotherapy
3. Incorporate health and wellness promotion in clinical practice
4. Manage patients with surgical problems
5. Facilitate ongoing care planning
6. Know his limitations and seeks appropriate consultation

C. PROCEDURAL SKILLS
1. Prepare patient for procedure
2. Competently perform procedures relevant to General Internal
Medicine
3. Provide care following procedure

D. MANAGEMENT OF ACUTE MEDICAL PROBLEMS
1. Recognize and manage the critically ill patient
2. Manage specific acute medical problems
3. Communicate with patients and their families in an
emergency situation

E. MANAGE PATIENTS WITH UNDIFFERENTIATED
PRESENTATIONS
1. Manage patients with undifferentiated presentations (eg,
Chest pain, cough, weight loss, etc)


F. MANAGE PATIENTS WITH COMMON DISORDERS OF ORGANS
1. Disorders of the cardiovascular system
2. Endocrine and metabolic disorders
3. Disorders of the gastrointestinal system
4. Disorders of the haemopoetic system.
5. Mental health disorders
6. Disorders of the musculoskeletal system
7. Disorders of the neurological system
8. Disorders of the renal and genitourinary systems
9. Disorders of the respiratory system
10. Skin disorders

G. MANAGE PATIENTS WITH DEFINED DISEASE PROCESSES
1. Manage patients with neoplastic diseases
2. Manage patients with genetic disorders
3. Manage patients with infectious diseases
4. Manage patients with electrolytes and acid base disorders
H. MEDICINE THROUGHOUT THE LIFESPAN
GROWTH AND DEVELOPMENT
1. Manage common presentations in adolescents
2. Manage common presentations in pregnancy
3. Manage common problems associated with the menopause
4. Manage problems in the older patient
5. Manage patients at the end of life


11.2. Outline of Core Syllabus:
Core Syllabus in which the Resident should acquire good
knowledge, clinical competence including appropriate
technical abilities is outlined below.
Respective applied basic sciences will be integrated with the
clinical science content 

1. Disorders of CVS

HeadlinesImportant Topics
Applied Basic scienceAnatomy 
Fetal circulation
Principle of 
Blood vessel 
Coronary anatomy
Coronary circulation 
Conducting System
Cardiac cycle
Cardiac performance 

Core Clinical KnowledgeSymptoms and Sign of Cardiovascular Disease
IHD
Angina
ACS
Arrhythmia 
Conduction defect
Heart failure
Cardiogenic shock
Valvular  Heart disease 
HTN
Dyslipidaemia
Infective endocarditis
Myocarditis
Cardiac myopathy
Pericardial effusion 
Congenital heart disease 
Peripheral Vascular Diseases 
Systemic disease of heart
Emergency Management Unstable Angina
Arrhythmia 
MI
LVF
Malignant HTN
Cardiac temponode
DVT with Pericardial effusion 
Critical limb ischemia 
CPR
Common Presentation 
Scenario
Chest pain syndrome 
Shock state
Cyanosis
Acute Pulmonary Oedema
Breathlessness 
Palpitition
Oedema
Investigation, procedure, interpretationECG
Echocardiography
Ambulatory 
Cardiac catherization
Cardiac pacing
ETT
CT venous cannulation 
CT angiography
Cardiology Question BankHere



2. Endocrine Disorder

HeadlinesImportant Topics
Applied Basic science
  • Classification, mechanism, and action of Hormone 
  • Hypothalamic regulatory hormone 
  • Pituitary Hormone
  • Adrenal cortex
  • Adrenal Medulla 
  • Pancreas 
  • Thyroid 
  • Physiologic responce in pregnancy
Core Clinical Knowledge
  • Symptoms and sign of endocrine Disorder
  • DM
  • Hyperglycemia & hypoglycemia 
  • Hypercalcemia & Hypocalcemia 
  • Thyroid nodule and cancer
  • Autoimmune thyroiditis
  • Hypothyroidism & hyperthyroidism 
  • Hypopituitarysm
  • Pituitary tumor
  • Multiple endocrine neoplasia 
  • Polycystic ovarian syndrome 
  • Obesity
  • Hypogonadism
  • Male sexual dysfunction 
  • Hyper and hypoadrenalism
  • Pheochromocytoma
  • Hypo and Hyper aldostrenism
Emergency Management 
  • DKA
  • HONK
  •  Hypoglycemia 
  • Tetanus
  • Addison crisis
  • Thyrotoxic crisis
  • Myxedoma coma
Common Presentation 
Scenario
  • Thurst
  • Polyurea 
  •  Hyperpigmentation
  • Fatigue 
  • Weekness
  • Weight gain
  • Weight loss
  • Appetite 
  • Hirsutism
Investigation, procedure, interpretation 
  • CT scan
  • MRI
  • Radioiodine scan of thyroid 
  • USG of Thyroid 
  • Short synactin test
  • X ray skull
  • OGTT,RBS,HbA1C,FBS
  • FNAC
  • Thyroid function test 
  • Thyroid autoantibody 


3. Disorder Of Gastrointestinal and Hepatopancreatic system

HeadlinesImportant Topics
Applied
Basic science
Regional anatomy: Surface Marking, Diaphragm, Thoracic duct, esophagus, stomach, duodenum, liver.

Physiology of stomach, pancreas, biliary tract,liver,small intestine and Large intestine.
Core Clinical KnowledgeSign and Symptoms of Gastrointestinal Disorder, 
Oral memedicine, 
Esophagitis,esophageal motility disorder,dysphagia and esophageal cancer.
PUD,
Celiac disease, 
Gallbladder Diseases,
Alcoholic liver diseases, 
Acute viral hepatitis and chronic viral hepatitis, 
CCirrhosis with Portal HTN,
mergency Management  
Common Presentation 
Scenario
 
Investigation, procedure, interpretation 
Endoscopy 
Colonoscopy


4. Disorder of Haemopooetic system

HeadlinesImportant Topics
Applied Basic science
  • Anatomy and Physiology of Hematology releted
Core Clinical Knowledge

Emergency Management  
Common Presentation 
Scenario
 
Investigation, procedure, interpretation 
Bone marrow

5. Infectious Diseases & Tropical Medicine

HeadlinesImportant Topics
Applied Basic science
  • Physiological change
Core Clinical Knowledge

Emergency Management  
Common Presentation 
Scenario
 
Investigation, procedure, interpretation 
ELISA

6. Disorder of Genitourinary System

HeadlinesImportant Topics
Applied Basic scienceAnatomy and physiology of Urinary and reproductive system

Core Clinical Knowledge
Emergency Management  
Common Presentation 
Scenario
 
Investigation, procedure, interpretation 
X-ray KUB,
Uroflowmetry,
IVU.


 7. Disorder of Nervous System

HeadlinesImportant Topics
Applied Basic scienceAnatomy and physiology of Nervous system
Core Clinical Knowledge
Emergency Management  
Common Presentation 
Scenario
 
Investigation, procedure, interpretation 
EEG,CT,MRI


8. Endocrine Disorder

HeadlinesImportant Topics
Applied Basic scienceAnatomy and physiology of Endocrine system
Core Clinical Knowledge
Emergency Management  
Common Presentation 
Scenario
 
Investigation, procedure, interpretation 
Thyroid Function test, 
OGTT,
HBA1C,


9. Disorder of Masculosceletal system

HeadlinesImportant Topics
Applied Basic scienceAnatomy and physiology of Urinary and reproductive system
Core Clinical Knowledge
Emergency Management  
Common Presentation 
Scenario
 
Investigation, procedure, interpretation 
  • Joint fluid aspiration,
  • Intra-articular injection 
  • Interpretation of Radiological,immunological and serologic  Test. 



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